Black children are more likely to die after surgery than their white peers, study says

A study found Black children were more likely than white children to die after common surgeries, mirroring similar disparities found in adults.

Researchers at Nationwide Children’s Hospital in Columbus, Ohio found that Black children were nearly 3.5 times more likely to die within 30 days after surgery compared to white peers.

The study, published Monday in the peer-reviewed journal Pediatrics, examined national data on nearly 173,000 operations from 2012 through 2017, where appendix removal and orthopedic operations were among the most common surgeries.

While there were few overall deaths, 23 Black children died within 30 days of surgery compared with 13 white children.  

“Generally, we expect that healthier patients should do well with surgeries. Healthy kids have low complication rates,” lead study author Dr. Olubukola Nafiu, pediatric anesthesiologist and vice chair for Academic Affairs and Research at Nationwide Children’s Hospital, said in a news release. “The expectation should be that complication rates and/or mortality among healthy children won’t vary based on racial category – what we found is that they do.”

Children were younger than 17 and were considered relatively healthy before their surgeries. While Black children had slightly more heart and digestive problems, pre-existing conditions were uncommon.

Dr. Shant Shekherdimian, pediatric surgeon at the University of California, Los Angeles, Mattel Children’s Hospital, said that while the difference in outcomes is a mere .05%, the study’s inclusion of more than 170,000 procedures reinforces its results. 

“When we take a patient to the operating room, we subconsciously assume that everyone comes to the operating room in equal circumstances and leaves the hospital to equal playing conditions,” he said. “This (study) contributes to the growing body of literature that shows that’s not the case.”

An editorial in Pediatrics says the research sheds new light on a concerning problem and should prompt doctors and hospitals to confront their own biases.

Differences in hospital quality and doctor bias have been suggested as contributors to racial health inequities in other research, but Nafiu said those factors are beyond the study’s scope and that reasons for the disparities found are uncertain.

“That’s the next assignment for my team and I,” he said.

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Nafiu and his team plans to review the data to see if other traditional explanations could account for these results such as socioeconomic status, type of hospital and postoperative recovery environment.

However, the observational study’s data is limiting. For example, his team doesn’t have access to the names of hospitals where patients received care.

“That’s important because we know that not every hospital has the level of expertise and the level of support when complications occur,” he said.

One thing Nafiu doesn’t want Black families to take away from the study is that hospitals and surgeries are unsafe for their children.

“Surgery is safe … mortality rates are low,” he said. “Our paper is not suggesting that African American parents should stop bringing their children to the hospital… we want to highlight differences to see what we can do so we can better serve the children that we care for.”

Contributing: Lindsey Tanner, Associated Press. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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